Healthcare Provider Details

I. General information

NPI: 1083871727
Provider Name (Legal Business Name): MARY ANN FARMER, DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 RUGH ST STE 3000
GREENSBURG PA
15601-5695
US

IV. Provider business mailing address

545 RUGH ST STE 3000
GREENSBURG PA
15601-5695
US

V. Phone/Fax

Practice location:
  • Phone: 724-837-2657
  • Fax: 724-837-5929
Mailing address:
  • Phone: 724-837-2657
  • Fax: 724-837-5929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberSC002434-L
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberSC002434L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC002434-L
License Number State

VIII. Authorized Official

Name: DR. MARY A FARMER
Title or Position: PODIATRIC PHYSICIAN
Credential: D.P.M.
Phone: 724-837-2657